Why Do Insurance Companies Deny or Devalue Claims?

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Insurance adjusters don’t want clients or claimants to understand their rights. Unfortunately, many of them take advantage of an injured victim’s vulnerability as well after they get hurt. At the end of the day, insurance companies have a business to run and want to maximize their profits. 

This means they need to take more premium payments while paying out less as compensation to injured people. Insurance companies routinely deny valid claims to prevent paying out compensation. And when they cannot outright deny a claim, they try and devalue it. However, they have the responsibility to explain why the claim is not worth the compensation you are asking for. This is where the role of a dedicated personal injury lawyer in New York comes in.

How Does an NYC Insurance Company Deny or Devalue Claims?

The last thing you need to worry about while recovering from your injuries is obtaining rightful compensation from the insurance company. It can be frustrating and stressful to fight with claims adjusters. Many personal injury victims settle for less than what they deserve. 

These are a few ways by which an insurance company may try to get out of paying rightful compensation:

  • They may get you to reveal damaging information by catching you off-guard and use that information against you
  • They may ask for a recorded statement that describes your injuries and events leading up to the crash 
  • Offer a quick but low settlement in exchange for you releasing the claim
  • Ask you to sign a medical authorization that allows them to pull your medical records and check for any pre-existing conditions
  • Dispute the policy holder’s liability following the car crash
  • Fight medical bills to devalue the claim
  • Convince you to stop seeking certain treatments by hinting that the insurance company will not pay for it
  • Compel you to settle by using delaying tactics
  • Try to confuse you into accepting a low offer by misrepresenting the rules and law

Reasons for Denying a Personal Injury Claim

Insurance companies are most certainly not trying to get you the best offer. They are not your friends. They deal with numerous injury claims every year that eats into their profits. These are a few reasons that insurance adjusters provide for denying claims:

1. Pre-existing medical conditions

Preexisting medical conditions make it difficult to pinpoint whether an accident worsened the condition. For instance, you may have degenerative joint disease or an old back injury that an insurance company may take advantage of. They may dispute legitimate claims based on this uncertainty. It is not easy to document changes in health following an accident.

You would need to provide testimonies from accident reconstruction experts and doctors to prove that your pre-existing conditions have been made worse by the accident. A capable NYC personal injury lawyer will know such experts. They will also have the experience to put together pieces to show how your health was affected by the wreck.

2. Delayed medical treatment

Personal injury victims don’t readily feel the extent of their injuries. In fact, certain medical conditions, such as traumatic brain injuries and herniated discs don’t present a full range of symptoms until after a few days or weeks following the initial trauma. This can cause delays in getting medical treatment. 

The insurance company may have an unfortunate view that delayed medical treatment is evidence of fraudulent claims. They may present the argument that the injuries are in fact owing to an unrelated incident after the accident. You should get help from a skilled personal injury attorney in New York if you believe that your medical records are not accurate. 

Sometimes, all it takes is a careful evaluation of complete medical records, including diagnostic tests to clear any omissions or errors. This also helps in establishing a firm connection between the collision and injuries. 

3. Insufficient coverage or lapsed policy

New York is a no-fault state. This means that you don’t need a liability-based system for recovering compensation from the insurance carrier. However, if you or the person responsible for your injuries failed to pay the insurance premiums on time, the insurance company may deny the claim by stating the policy had lapsed. 

4. Missing or inaccurate information

Insurance companies cannot deny claims just because the police report has incomplete information regarding the accident and your injuries. Every injury is not as obvious as a laceration or broken bone. Soft tissue and non-life-threatening injuries can take several days to weeks to appear following an accident. These injuries may not be mentioned in the police report. 

Insurance Companies May Carry Out Personal Character Attack

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A common way of minimizing claim value by insurance companies is putting the victim on trial instead of the negligent party that caused the accident and injuries. The goal of this exercise is to convince the victim that the jury won't sympathize with their predicament. These are a few tactics used by insurance companies for casting doubt on a victim’s character for minimizing the claim value:

  • Questioning victim credibility because of inconsistent recounting of facts
  • Using prior mistakes, such as criminal conduct or DUI to raise doubt
  • Introducing a history of emotional problems or mental illness
  • Suggesting your claim is an attempt at extorting money by bringing up your previous personal injury claims
  • Bringing up workplace concerns, such as being fired due to positive drug test

Denying Liability after Personal Injury

Insurance companies in New York may deny your claim completely or attempt at convincing you that the at-fault party (insured) did not have any liability in causing your accident. Unfortunately, many victims simply walk away when their claim gets denied by an insurance company. 

This is where an experienced personal injury lawyer comes in useful. These are a few tactics used by insurance companies for denying rightful compensation:

  • They may claim that you were 100% at-fault for the accident
  • They may deny that the conduct of the insured was unlawful, improper, or negligent
  • They may claim that an earthquake, weather event, or war was responsible for the accident
  • They may state that an unidentified person or a known third party was responsible for the accident
  • They may cite exclusions under the insurance policy for denying coverage
  • They may use expired statute of limitations

Steps to Take if Your New York City Insurance Claim is Denied

It can be frustrating to have your personal injury claim denied. However, you should not quit. You should fight the denied claim if you think that your claim is viable. It is best that you speak with an experienced personal injury attorney if in doubt. A capable attorney can assess the value of your claim and educate you on your legal rights. They can also explain your legal options during the initial consultation. 

The injury lawyer you hire will be on your side unlike the insurance adjuster. The right attorney will offer practical and honest legal advice for you to fight for fair compensation. Your attorney will also help you collect and organize necessary evidence to build a strong case. They can negotiate on your behalf and subpoena records. This can improve your chances of obtaining a fair settlement and give you the peace of mind you require to focus on your recovery and healing. 

When to Speak with a Personal Injury Attorney in NYC?

You should hire a personal injury attorney immediately if you are not at-fault and have suffered injuries. Most personal injury accidents are life-altering. They can leave you with significant property damage, injuries, and financial hardships. 

Hiring a competent personal injury attorney gives you the upper hand you need in the following situations:

  • You have admitted fault even when it was not your fault
  • You are unable to prove negligence of the at-fault party
  • You believe you may have a wrongful death lawsuit
  • You have suffered extensive property damage

Insurance claims process is not something you should take lightly. It is vital that you focus on your health to recover quickly. By hiring professionals, you can enjoy peace of mind. You can also be sure that the negotiations with insurance company are being handled by an expert. 

Consult With a Skilled Personal Injury Attorney Today

The personal injury attorneys at Rosenberg, Minc, Falkoff & Wolff, LLP have handled dozens of personal injury claims. If the insurance company denies or devalues your claim, we have the necessary resources to take the case to trial. We have helped several personal injury victims attain rightful compensation. 

Schedule an appointment today with a knowledgeable attorney. We offer free case evaluations so that you can better understand your available legal options. Get in touch with us today by calling at 1-800-660-2264 or using our online form


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